Pancreatitis
Pancreatitis refers to inflammation of the pancreas. This is a leaf shaped gland that is present behind the stomach and secretes enzymes that can digest starches, protein and fats. The pancreas also contains cells that secrete insulin. The duct of this gland joins the lower common bile duct and opens into the duodenum (small intestine) via a common orifice (Sphincter of Odi).
Pancreatitis results from two major causes: Gallstones or Alcohol use. Other causes include increased blood fats (triglycerides) or peptic ulcers.
Patients who have gallstones may pass small stones through the common bile duct and this may causes transient obstruction to the pancreatic duct resulting in pancreatitis.
Patients with Chronic alcohol use develop chronic pancreatitis.
What are the symptoms of pancreatitis?
Patients with pancreatitis present with pain that is the upper mid abdomen and often radiates to the back. This is often associated with vomiting. Other symptoms include jaundice (yellow eyes from biliary obstruction), fevers, abdominal distention etc
How is pancreatitis diagnosed?
Blood tests (serum Amylase, Lipase) or CT scan usually establishes a diagnosis of pancreatitis. Ultrasound of the abdomen can reliably diagnose stones in the Gallbladder. In pancreatiis due to biliary obstruction from stones in the Bile Duct, ERCP – Endoscopic retrograde Cholangio pancreatography (placing an endoscope in the duodenum and canulating the bile duct) may ne necessary to extract the stones.
How is pancreatitis treated?
Patients who develop pancreatitis due to alcohol need to stop drinking. If they continue, they can develop recurring attacks that will destroy the gland and cause pancreatic insufficiency (diarrhea from loss of pancreatic enzymes and diabetes from loss of insulin secreting cells).
Patients with pancreatitis due to gallstones need to have the gallbladder removed surgically usually laparoscopically. Those patients who have stones in the common bile duct need ERCP to remove the stones before gallbladder surgery.